Accident, Injury or Dangerous Occurence Form

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Selwyn College
Risk Management Procedure
Accidents requiring prompt notification to the HSE
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Fracture other than to finger, thumbs or toes;
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Amputation;
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Dislocation of shoulder, hip knee, or spine;
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Loss of sight (temporary or permanent);
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Chemical or hot metal burn to eye or any penetrating injury to the eye;
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May 2012
RMP/7a
Issue: 1
Injury resulting from an electric shock or electrical burn leading to
unconsciousness or requiring resuscitation or admittance to hospital for more
than 24 hours;
Any other injury: leading to hypothermia, heat-induced illness or
unconsciousness: or requiring resuscitation: or requiring admittance to
hospital for more than 24 hours;
Unconsciousness caused by asphyxia or exposure to a harmful substance or
biological agent;
Acute illness requiring medical treatment, or loss of consciousness arising
from absorption of any substance by inhalation, ingestion or through the
skin;
Acute illness requiring medical treatment where there is reason to believe
that this resulted from exposure to a biological agent or toxins or infected
material.
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Any accident resulting in an absence from work of 10 days or more.
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See also procedures for Death of a Student (RMP/11q).
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